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FDA Approves Cymbalta (Duloxetine) for Fibromyalgia

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The U.S. Food and Drug Administration has approved CymbaltaR (duloxetine) as a prescription drug for treatment of Fibromyalgia pain, according to an announcement today by the Indianapolis-based drug maker Eli Lilly & Co. It is only the second drug approved explicitly for treatment of Fibromyalgia. The first, the anticonvulsant and pain drug LyricaR (pregabalin), gained FDA approval in June 2007. Both drugs come with serious safety information.

Duloxetine is a serotonin-norepinephrine reuptake inhibitor (elevator), previously approved to manage major depressive disorder, general anxiety disorder, and diabetic peripheral nerve pain. Serotonin and norepinephrine in the brain and spinal cord (central nervous system) are believed to mediate core mood symptoms and help regulate the perception of pain. Fibromyalgia is generally considered a disorder of increased CNS sensitivity to pain characterized by chronic widespread pain and other symptoms.

To view a series of slides on how Cymbalta is thought to work, click here. By comparison, Lyrica is thought to work by controlling excessive release of several neurotransmitters, "reducing the number of 'extra' electrical signals that are sent out from overexcited nerves in your body." See "Lyrica: Mechanism of Action."


The Initial Eli Lilly Press Release, including safety information, is as follows.

INDIANAPOLIS, June 16, 20 – The U.S. Food and Drug Administration (FDA) has approved Cymbalta® (duloxetine HCl) for the management of fibromyalgia, a chronic widespread pain disorder. Cymbalta is the first serotonin- norepinephrine reuptake inhibitor with proven efficacy for reducing pain in patients with fibromyalgia. The fibromyalgia indication represents the second FDA-approved use for Cymbalta for a pain disorder, demonstrating the medication's analgesic effect.

"The approval of Cymbalta is important because it provides physicians and patients with a new treatment option shown to help reduce pain and improve functioning in this difficult-to-treat disorder," said Madelaine Wohlreich, M.D., medical advisor and research physician at Lilly.

The cause of fibromyalgia remains unknown; however, scientists believe it may be related to some combination of changes in brain and spinal cord chemistry,(i) genetics(ii) and stress(iii). Some researchers believe fibromyalgia is a disorder of increased sensitivity to pain. Although the way Cymbalta works in people is not fully known, medical experts believe it increases the activity of two naturally occurring substances called serotonin and norepinephrine. These substances aid communication in many areas of the brain and spinal cord that affect emotion. Research also suggests that these substances are part of the body's natural pain-suppressing system.

"The FDA approval of Cymbalta for the management of fibromyalgia is another important step in the efforts to ensure that people with fibromyalgia will have the availability of effective medications to help reduce the chronic, widespread pain of this life-altering disorder," said Lynne Matallana, president of the National Fibromyalgia Association and a fibromyalgia patient.

Fibromyalgia is estimated to affect 2 percent of the U.S. population – approximately 5 million people – the majority of those diagnosed being women.(iv),(v) The disorder is characterized by chronic widespread pain and tenderness. Some patients may have additional symptoms.(i) Although there is no known cure for fibromyalgia, some physicians recommend a comprehensive care plan that can include education, medication, and lifestyle changes to help manage the symptoms of the disorder.(i)

"In fibromyalgia, there is no one-size-fits-all approach to managing the disorder," said Dan Clauw, M.D., professor of medicine in the University of Michigan's Division of Rheumatology and director of the Chronic Pain and Fatigue Research Center at the University of Michigan.

The approval marks the fourth disorder that the FDA has approved for Cymbalta. In addition to fibromyalgia, Cymbalta is approved for the management of diabetic peripheral neuropathic pain (DPNP) and the treatment of major depressive disorder and generalized anxiety disorder, all in adults age 18 years and older.

Additional important changes have been made to the Cymbalta prescribing information, including updates to the Warnings and Precautions section. Full prescribing information can be found at http://www.cymbalta.com.

Data Highlights
Lilly established the efficacy of Cymbalta in two pivotal three-month clinical trials involving 874 patients with fibromyalgia. In both studies, Cymbalta reduced pain at study endpoint compared with placebo as measured by the Brief Pain Inventory (BPI) 24-hour average pain scale.(vi),(vii) The BPI is a scale that measures the severity of pain.

Significant improvement in pain for Cymbalta vs. placebo was observed in the first week of each study. Fifty-one percent and 55 percent of patients on Cymbalta had a 30 percent improvement on the BPI at endpoint (clinically meaningful relief is considered at least 30 percent pain reduction(viii)).

In addition, 65 percent and 66 percent of patients taking Cymbalta 60 mg daily reported feeling better at endpoint as measured by the Patient Global Impression of Improvement (PGI-I). The PGI-I is a patient-rated scale that evaluates how much improvement has occurred since beginning treatment.

Cymbalta 60 mg was superior to placebo on the Fibromyalgia Impact Questionnaire (FIQ) Total Score. The FIQ is a scale that is used to assess and evaluate the impact of fibromyalgia on aspects of health and functioning believed to be most affected by the disorder.

In four pooled studies, the most commonly observed adverse events in Cymbalta-treated patients with fibromyalgia (greater than or equal to 5 percent and at least twice placebo) were nausea (29 percent), dry mouth (18 percent), constipation (15 percent), decreased appetite (11 percent), sleepiness (11 percent), increased sweating (7 percent) and agitation (6 percent). In the placebo-controlled clinical trials, the overall discontinuation rates due to adverse events for Cymbalta vs. placebo were 20 percent and 12 percent, respectively.(ix)

About Cymbalta
Serotonin and norepinephrine in the brain and spinal cord are believed to both mediate core mood symptoms and help regulate the perception of pain. Based on preclinical studies, Cymbalta is a balanced and potent reuptake inhibitor of serotonin and norepinephrine that is believed to potentiate the activity of these chemicals in the central nervous system (brain and spinal cord). While the mechanism of action of Cymbalta is not fully known, scientists believe its effects on depression and anxiety symptoms, as well as its effect on pain perception, may be due to increasing the activity of serotonin and norepinephrine in the central nervous system.

Cymbalta is approved in the United States for the acute and maintenance treatment of major depressive disorder, the acute treatment of generalized anxiety disorder, and the management of fibromyalgia and diabetic peripheral neuropathic pain in adults age 18 years and older. Cymbalta is not approved for use in pediatric patients.

Important Safety Information
Cymbalta is approved to treat major depressive disorder and generalized anxiety disorder, and to manage diabetic peripheral neuropathic pain and fibromyalgia. Antidepressants can increase suicidal thoughts and behaviors in children, adolescents, and young adults. Patients should call their doctor right away if they experience new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Cymbalta is approved only for adults 18 and over.

Cymbalta is not for everyone. Patients should not take Cymbalta if they have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI), are taking Mellaril® (thioridazine), or have uncontrolled glaucoma. Patients should speak with their doctor about any medical conditions they may have including kidney problems, glaucoma, or diabetes. Patients should talk to their doctor if they have itching, right upper belly pain, dark urine, yellow skin or eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported. They should also talk to their doctor about alcohol consumption. Patients should tell their doctor about all their medicines, including those for migraine, to avoid a potentially life-threatening condition. Taking Cymbalta with NSAID pain relievers, aspirin, or blood thinners may increase bleeding risk. Patients should consult with their doctor before stopping Cymbalta or changing the dose and if they are pregnant or nursing.

Patients taking Cymbalta may experience dizziness or fainting upon standing. The most common side effects of Cymbalta include nausea, dry mouth, sleepiness, and constipation. This is not a complete list of side effects.

If patients have any questions, they should talk to their doctor before taking Cymbalta.

For full patient information, visit http://www.cymbalta.com.

For prescribing information, including Boxed Warning and medication guide, see http://pi.lilly.com/us/cymbalta-pi.pdf.

Note: This press release contains forward-looking statements about the potential of Cymbalta for the management of fibromyalgia, and reflects Lilly's current beliefs. However, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of development and commercialization. There is no guarantee that the product will continue to be commercially successful. For further discussion of these and other risks and uncertainties, see Lilly's filings with the United States Securities and Exchange Commission. Lilly undertakes no duty to update forward-looking statements.

Cited Sources:
(i) Leventhal, LJ. "Management of fibromyalgia." Annals of Internal Medicine. 1999; 131: 850-858.
(ii) Arnold, L, et al. "Family Study of Fibromyalgia." Arthritis & Rheumatism. 2004; 50(3): 944-952.
(iii) Bennett, Robert M., et al. "An Internet Survey of 2,596 People with Fibromyalgia." BMC Musculoskeletal Disorders. March 9, 2007. 8:27.
(iv) Lawrence, et al. "Estimates of the Prevalence of Arthritis and Other Rheumatic Conditions in the United States." Arthritis and Rheumatism. 2008; 58(1):31.
(v) Wolfe, F, et al. "The Prevalence and Characteristics of Fibromyalgia in the General Population." Arthritis and Rheumatism. 1995; 38(1):19-28.
(vi) Arnold, L. et al. "A Randomized, Double-Blind, Placebo Controlled Trial of Duloxetine in the Treatment of Women with Fibromyalgia With or Without Major Depressive Disorder." Pain. 2005; 119:14.
(vii) Russell IJ, et al. "Efficacy and Safety of Duloxetine for Treatment of Fibromyalgia in Patients With or Without Major Depressive Disorder: Results From A Six-Month, Randomized, Double-Blind, Placebo-Controlled, Fixed-Dose Trial," Pain. 2008: In Press.
(viii) Farrar JT, JP Young Jr., L LaMoreaux, JL Werth, RM Poole. "Clinical Importance of Changes in Chronic Pain Intensity Measured on an 11-point Numerical Pain Rating Scale." Pain 2001; 94:149-158.
(ix) Cymbalta Prescribing Information
Source: Eli Lilly and Company

Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat or cure any disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.

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15 thoughts on “FDA Approves Cymbalta (Duloxetine) for Fibromyalgia”

  1. damaquilts2 says:

    This may work for some but I have to agree it is a horrible drug for me. The free mental health center here was handing it out before it got all the advertiseing that is going on now. I was on it over a year and I thought about suicide constantly, slept all the time , could not string 2 words together without concentrating I was hearing voices I really thought I was going nuts. I came very close to just ending it all together . I could barely move. I hated it and came off it also when they messed up my refill time. I went through the migraines and its been awhile but I know it was almost two weeks before I could function again.
    They put me on another med that the name escapes me now but it was an anti seizure medication. It made me violent and I almost strangled my daughters cat, was costantly blowing up over little things and throwing stuff. Went through almost all of our coffee cups. And the therapist at the clinic thought it was funny.
    Then they tried Neurotin. That made me feel like I was having a heart attack after I took it, severe pain in the neck and jaw and upper back area.
    I knew I was extremely sensitive to drugs before all this started but now I have to be extra careful. I have stayed with alternative products, and have learned to live with the pain and work around the fatigue.

    1. jsellie says:

      Last year, I was prescribed Cymbalta for my unrelenting Fibromyalgia and CFS. I began at 30 mg. per day. The first week I did not notice ANY changes in my pain or my depression. But, at the end of the first week,things changed RAPIDLY. My speech was out of control and I made no sense, slurring all my words. I was so depressed I could barely move. My pain was WORSE. I became suicidal and jumped out of a moving vehicle going 25 mph. I have no idea how I survived. It was well below zero, being winter, and I climbed way up the mountains ( how could I do this when I was in so much pain??) where there are bear and mountain lions. I know… I live out here and we have all seen them.

      The EMT’s found me, passed out, with hypothermia. I was taken to a hospital and then moved to the PSYCH ward where my dose was DOUBLED to 60 mg. The pyschiatrist told me I was trying to manipulate my fiance???? What a JERK! My regular doctor came in several days later, and told me that Cymbalta was TOXIC for me and it did nothing to relieve PAIN. So has EVERY doctor I have seen for my Fibro since then. The FDA has made a HUGE MISTAKE. BEWARE THOSE WHO PEDDLE IT TO YOU. IT IS THE MOST HORRIBLE DRUG EVER MADE. AND, EVERY RHEMATOLOGIST I HAVE SEEN HAS TOLD ME IT DOES NOTHING, NOT A SINGLE THING FOR PAIN. IT DID NOT FOR ME, BUT IT DID MAKE ME HORRIBLY SUICIDAL. NOW I HAVE TO LIVE WITH THE KNOWLEDGE THAT I WAS STUCK IN A PSYCH WARD, AGAINST MY OWN WILL, FOR AN ENTIRE WEEK. OH, AND I FORGOT TO MENTION THE WITHDRAWALS. IT WAS LIKE COMING OFF OF HEROIN. ALL MY FIANCE COULD DO WAS HOLD ME WHILE I SCREAMED IN PAIN FROM MIGRAINE HEADACHES THAT WOULD NOT RELENT AND THE INCESSANT VOMITING.


      1. Corvettegirl says:

        I just wanted to reply to the lady that posted that Cymbalta drove her crazy and it was toxic. That is not the case with Cymbalta. I’m sorry it did not work for her, but in my case, it helps tremendously. I have chronic nerve pain, called vulvodynia, over 200,000 women have this chronic nerve pain condition and I tried several drugs and they did nothing, until I tried Cymbalta. Yes, it does have side effects: grogginess, constipation, dizziness, but I stay at home mostly and I deal with it. Cymbalta is the only drug that decreased my horrible, stabbing, burning pain. I am still in pain, but it helped- a lot. So, please just try it if you have any kind of nerve pain.

      2. fransmom says:

        Getting Lyrica and Cymbalta FDA approved is kind of a two-edged sword for those of us with FM. Getting approval gives our disease legitimacy – see? even drug companies think it’s real! – but on the other hand, if it doesn’t work, docs are going to think that we really DONT have FM – you’re just one of those making it up, not a REAL FM case. I think we all have to realize that even with FDA approval, Lyrica has only a 30% success rate – that is, it only helps 30% of us – Cymbalta claims to have about a 50% success rate (we’ll see with more studies if this holds true). We all know how difficult the symptoms of FM are and if you’re one of those that either of these drugs works for the relief is tremendous; however, we all also know that for many Lyrica and Cymbalta can make things either no different or much worse. I tried both, and while neither made me suicidal, have more pain or other major side effects, neither of them made me feel better either and the minor side effects of dizziness and sleepiness made it harder for me to do my job. I chose to go off each one and am back to simply Tramadol and sometimes Vicodin for pain and a tiny dose of Elavil for sleep. This doesn’t make it all go away, but it’s the way I can function best right now.

        I heard a show on NPR after Lyrica was FDA approved, and the doctor gave this advice: The key if you’re thinking about going on either drug is to assess the risks and the possible benefits then decide if it’s worth it for you. You ask the question, I know the potential for relief, I know the potential for problems, I know how bad I feel right now – am I willing to try? Any drug is a risk in terms of short and longterm side effects, but if it makes you able to function as a person NOW, are the potential side effects worth it? For me, they weren’t ’cause I didn’t see improvement, but for others, Lyrica and Cymbalta have been their salvation.

        Anyway, hope this helps folks with the very hard decisions about taking on a new drug –


      3. pcynthia says:

        However you may be the one person in a million that had a bad reaction to this drug. For the rest of us it has been a godsend, I’ve been waiting for a drug like this for over 20 years. It does so many things for me. I was given it for the deepest depression I’ve been in since I was 14. My pain doctor gave it to me and told me it “might” help with the pain. Might was a small word for the relief I felt all over my body. It’s the first thing that has worked this well since I was diagnosed with FM, CFS in the last 20 years. I can’t imagine why you had withdrawal from this. It is not that addictive, not at all in my opinion. I’ve had to get off for a few days because frankly I could not afford to get another prescription and had no withdrawal at all. If you are a migraineur then the reaction you were having could have been from the migraine instead of withdrawal. However having never been on herion I don’t know what that is iike but would assume it is similiar to a migraine. I do know incessant vomiting is related to migraines. I would believe that your other doctor was not as well read on Cymbalta since it is so new but it is specific for nerve pain. The side effects are relief of anxiety and depression. Is it possible that you were going into a really severe case of migraine and that caused the other symptoms? I know the drug has helped and will help millions of people who suffer from multi-symptom disorders. Any drug can cause bad reactions in some of the people who take it. That doesn’t mean we throw it out since it does so well for the rest of us. It’s just not the drug for you. I wish it had helped. The nerve pain that I suffer from, the cymbalta is the best thing in the world. It’s not simply a pain reliever that you take just for general pain.

      4. raabfmly says:

        I have been listening to the adds and thought it was a wonder drug. I even asked my doctor – and we thought we wait to see if something else worked. I will not be asking again. How scary. I had a similar experience with Zoloft. When I’d tell my doctor I wasn’t reacting well to it – they’d increase the dose – then gave me Zantac for acid – and an antibiotic for kidney pain – and I nearly ended up in the hospital. It drives me crazy. I am afraid of drugs – but know I need something to help the pain.
        Another Fibro CFS Sufferer

      5. wrytstuff says:

        I feel so bad for people who have negative experiences with new medications. I am so sorry you are still suffering. I do want to say CONGRATULATIONS ON “COMING OFF OF HEROIN”!!! That is certainly something to toot your horn about. How long were you addicted? I do hope someone invents a medication that will help you. Your entire message reads as a desparate cry for help.

        -Signed, a happy and active fibro

      6. krw131 says:

        First of all, I do not have fibromyalgia, I have CFS…was diagnosed about 15 years ago and have never found anything that really works on a daily basis for the aching, flu-like feeling and the muscle aches, etc.

        But, my doctor thought I should try Lyrica, just so we would know if it worked, so we wouldn’t always wonder…Since starting it around the beginning of July, I have felt SO much better. BUT, the weight gain has become a problem and the swelling of the hands and feet is driving me crazy.

        I hate to think about going off this med because it really has helped, but I can’t afford to gain any weight; I’m already too heavy! I read that some of the people in the initial studies of the drug gained 7% of their starting weight in 14 weeks.

        I even started riding my exercise bike one hour a day (I wasn’t doing anything before this)…and I’m still gaining weight. I’m attending Weight Watchers, so I think I’m following a pretty good diet.

        Any ideas? Any suggestions for a different medication? I’m at the end of my rope….just very frustrated.

        I’ve never posted anything here before, so I hope I followed all the rules and protocol.

        Thanks, in advance, for your help.

    2. andilynn says:

      Hi! I’m new to this chat. But I just wanted to say that I’ve been on Cymbalta for at least one year, and it, along with some other meds, has helped both my depression and my FMS pain.It was prescribed by my psychiatrist for depression, but he chose it partly because he had read some literature that suggested it could help with chronic pain.
      So, I just wanted to put this out there to say that everyone is different. What helps one person may not help another, and vice-versa.

    3. dinodebi says:

      I was actually placed on Cymbalta in the spring of 05. Just after being diagnosed w/CFS and Fibro. I was able to notice a huge diff in the decrease of pain w/in the first week. Soon after I was able to go back to work. Since then, when I don’t get my scrips filled fast enough, I can notice a difference when not taking it. It seems to help two-fold for me, both as an antidepressant, and as a pain inhibitor. I still flare and have bad days, but nothing as bad as the months before starting it.

    4. maltese says:

      I am on Cymbalta, for about 4 years now, and it is working quite well for me. I understand, it may not work for everyone, but any of these drugs, is all trial and error. What works for one person, may not work as well for another. We all have different body chemistries, and for that reason, do not make a decision, on a negative response, as was seen, in the beginning of this, “Article’s Response”. For me, it has been a “God Send”, it helped me to cope, with this illness. Yes, it may make you a bit more tired, but I rest when I can, because, the reality for me is, less sleep, makes me feel worse. This has actually helped me to feel more relaxed, with less anxiety, and that has helped too! The only other thing, is the medication, is expensive. So, if you don’t have a good drug plan, investigate other pharmacies, out of state, that can have it delivered to your door. I actually, deal with an out of state pharmacy, through my Insurance Company. My opinion, is, “if you are in a lot of pain, don’t be afraid to try something different”, because, all of these drugs, are trial and error. If it doesn’t help you, then just realize, it doesn’t work with your body chemistry, and go on to something else.

    5. leaknits says:


      Cymbalta doesn’t do jack for pain. What it does do is succeed in making the guinea pig oops I meant patient worse, and then it’s the fault of the patient if the junkmed does nothing but harm.

      Dr out here in CA gave me the usual bs that he says about a-d’s when I try to get him to understand that in my file are notes about “Do not give me SSRIs, SNRIs, TCAs.” “Ohhh,” he claimed, “this one is different.”

      Its’ only difference as far as I can tell is in shape and color of the pills.

      Cymbalta does nothing at all for depression, unless we count making it incredibly worse as doing something. Isn’t the body count at Big Pharma high enough yet?

      It’s a double edged sword as another poster wrote. If we say a med doesn’t help or that it hurts us, we get told that we don’t have the problem it’s meant for.
      Then when dear dr goes “off label” because he heard that someone said something made for illnesses we don’t have might help anyway, and we react badly to THAT, we get more of dr’s scorn.

      It’s ridiculous to expect any of those people with the alphabet soup letters behind their names to really help; my gosh if they helped us we wouldn’t have to see them any more.


    6. fibroflo says:

      I have been on Cymbalta for almost 2 1/2 years now, and I have definitely noticed a difference. Although, I still have violent flare-ups at times (severe stress, extreme cold/heat or weather change, etc.) there is not a day that I don’t have a problem with my muscles and cognitive functions. I also have osteoarthritis and degenerative disc disease. I take 60 mg capsules twice daily of the Cymbalta, along with Vicodin ES 4 times daily. This sounds like a lot, but after 8 years, I can get out of bed, do a few things around the house, laundry, and feel as though I do have some sense of well-being and I can loose myself in my scrapbooking totally – this has been my salvation – to become completely immersed in this hobby. But, this was impossible before starting the Cymbalta. I must have taken every drug known to man to get a handle on the pain and the inevitable cycle of stress-pain-guilt-stress-ad nauseum. I tried Lyrica after praying for its release two years before it was approved. I lasted less than two days on it. I nap every afternoon, or at least lie down for an hour or so (I find this helps me make it through the day), and on the second day, after extreme nausea, dizziness, and stiffness, I woke and realized the only thing I could move was my eyes. This lasted almost 45 minutes. I finally was able to make myself roll off the sofa onto the floor with my legs hooked around the coffee table leg and managed to pry my legs apart, then using my feet to pry my arms apart and then to use them to move the rest of my body. I was not afraid, only so sad that my husband would come home from work and find me in a little dead bundle. I was finally able to get up and walk. I reported this to the pharmacy, my rheumatologist, my primary internist, and my orthopedic surgeon. No one had ever heard of this side effect before, and they only said that never to take it again. DUH! This did not happen again once I stopped the Lyrica. This only goes to show that these are such strong drugs that we allow into our bodies, and the “degree of the need to not hurt” that we put ourselves in the position of trying ANYTHING for relief. Cymbalta and Vicodin ES taken by the clock seems to help me more than anything else I’ve tried before, but this is an insidious life-altering syndrome that has all but destroyed my life – I am no longer employable and had to leave a high-powered position, was denied disability from my employer’s insurance because “you have been working with this for several year, there is no reason why you cannot continue to do so.” Try standing to work at a computer crying because you hurt so badly, and you have post-it notes all over your desk so you won’t forget something. Hurray for Cymbalta – at least we are being counted as worthy of attention by the medical field profession. I may not be pain-free and I don’t know from one day to the next what I will wake up to, and my spouse still doesn’t understand or want to talk to me about it (no lab tests or x-ray proof) but I am fine with me. Try it if your physician suggests it, it just may help, and right now that may be all we have.

    7. raabfmly says:

      I understand this too. I work full time – at a desk but by the end of the day I feel like I’m so fatigued I feel like I can hardly breath. I am very sensative to medications. I take about a fourth of a pain pill -hydro-codo or some such thing. I take Alieve occasionally. I take 1/2 Alprazolam at bed time to sleep – along with about 12 mgs of Benadryl- I can sleep about 6 hours with this combo. I just ache all the time. Just really don’t know what to do. Have a bottle of Lyrica – haven’t taken one – this after the pharmacist told me many people were complaining of halusanations ! I don’t need that. Took Neurotin for a week – felt drugged. It seems a loosing battle at times. Donna

  2. weedbe says:

    I just went off Lyrica and on to Cymbalta. I was taking lexapro for depression and Lyrica of fibromaylgia and it made sense to see if I could get aaway with one medication. Also I am moving into menopause and put on 35 lbs in th elast year. I started seeing a naturopath and she has me eating according to my blood type–I seem to be not so hungry–carbo-craving–and also seem to be losing a little weight. You might something more natural out but don’t so it yourself –talk to some kind of professional even if it’s just a dietician. Good luck–i have had migraines/clusters/daily headaches and fibromyalgia for ten years since a bad bout of Lyme Disease–you just have to keep plugging until you find people (doctors and many others) who will work with you.

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